Search This Blog

Interventions: The Screenshot

Before intervention became a household word, disseminated via television as a strategy to sober people up, therapists used it universally as any strategy designed for change.

An intervention is something a therapist uses to change behavior that doesn't work for the client. Or it might add a behavior that works much better.

Much of therapy is about finding ways to stop something or to start something.

Here's an example, an intervention I thought up working with a client who wanted to lose weight. But the intervention can be altered to fit any behavioral or emotional issue, too. Anything that needs reinforcement, reminders. A pretty big set.

Just a reminder that the example below is fictitious, a variant of what really happened.

We're bemoaning the fact that at a hundred pounds overweight, the patient needs to use multiple behavioral strategies to cut down her calories, and she needs to walk every day. She does nothing but eat and sleep. The emotional reasons, the psychology, has all been discussed, purged, but the numbers on the scales still go up. Sometimes down, then up again.

Like most of us, she has a cell phone. Hers tells her when she has email.

"Can you just send me an email everyday?" she asks.

If I can't remember to call a sick friend once a month, do you really think I'll manage to do that, email you? No, this is your program, not mine.

But we come up with another idea. I print out the following, her reminder.

STOP EATING!

You want to be here to see grandchildren.

You don't want your kids to bury you in your forties.

Print-out obesity intervention

Screenshot-obesity intervention

Then she takes a picture of the printout, and with a little effort, tries to make it a screensaver.

The Home Screen Intervention

We had to reprint it again, condense the text, make it single spaced and compact, but eventually it worked and we made it into her home screen.

Now, every time she uses her phone, the message confronts her. We're chipping away at her denial.

Time will tell, certainly, if this is going to work.

Now you have the intervention. I'm still working on what mine should say.

One thing's sure. It is cheaper than buying the many apps on the market today, and if we keep changing the words to deliberately avoid desensitization, it can't hurt, might even be, effective.

Comments

My patients tell me that previous tries, being "nice" doesn't work, and that I'm supposed to be tougher, expect more of them so that they expect more of themselves. Obviously this isn't for everyone, and we tend to tune out what we always see anyway. But for those who want to look in the mirror, past their denial, a real reminder of their personal goals can be very helpful.

Popular Posts

It's a very simple concept, really. But I remember first hearing about it many years ago in graduate school and getting it, but not getting it, and what made it worse was that the instructor, Joy Johnson (where are you, Joy?) made a serious pitch, told us that if we didn't get it, basically, we would be only be so-so at this job. Whereas if we did get it, we had half a chance.

A patient ended up clarifying it for me, unintentionally, of course. Joy taught us that process is what's happening, the action, and that content is the story. There's a difference between seeing something, and hearing about it. The guy selling you a car is going to be friendly, and he'll tell you all about the features and wonders of the vehicle, but if he sells it to you, it is likely because of the way he worked you, not because it's such an awesome car.

I wrote this one to show you how badly I can blow a case, and to make suggestions to increase the odds it won't happen to you.

You people know me as therapydoc, but I do research and have a faculty appointment, too. One day I took a call, expecting it to be a client, but it was the dean asking me if I would please take on a funded project. There is this small problem, she tells me, of acquaintance rape.

Ultimately a new agency to treat college rape survivors off campus gets off the ground because of the project, and I get a paper out of it, present it to the annual meeting for the Council on Social Work Education. It's about how social workers should be treating rape.

But the following story happened years before, when all I had to go on was my fairly extensive knowledge of cognitive behavioral and exposure therapies for anxiety and post traumatic stress. I had used these tools for all kinds of abuse and assault, even for rapes that had happened in the past.

Maybe, instead of lovers, you start out as best friends. Or maybe there has always been chemistry. Maybe someone fixed the two up, thought you would work well together, and you did.

In each case things start out swimmingly, perfectly, and for awhile, maybe even a long while, it's magic, and there's attention and love, and that face I see on the leather sofa two feet away from me is pretty happy.

And the cynic in me waits for the other shoe to drop. Far be it from me to burst anyone's bubble. I'm not your mother. Let the fantasy last. We all need a little hope, and when someone is kind, when someone is attentive, when someone is flirtatious, well, it feels pretty good.

This is the new relationship paradigm, you know, love without commitment. With a divorce rate holding steady at one out of two, what is the point of the crystal and china? Why register at all? Surely weddings are expensive, and happiness a toss of the dice. I'd prefer to think, actually, that…